Individual provider Active NPI

Sophie Maynard, FNP

  • Nurse Practitioner
  • Skokie, IL
National Provider Identifier
1154105252
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.028140 Issued in IL
Practice address
9977 Woods Dr
Skokie, IL 60077-1057
Phone
(224) 364-2273
NPI assigned
Aug 21, 2023
Last updated
Aug 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.028140 IL Primary

Addresses

Primary practice location

9977 Woods Dr
Skokie, IL 60077-1057

Mailing address

4212 N Whipple St
Chicago, IL 60618-2516
Phone (708) 305-7882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231121000761 IL Practitioner - Nurse Practitioner 8628426251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Rush Medical College of Rush University, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

211 Waukegan Rd
Suite 200
Northfield, IL 60093-2724
Phone (847) 767-3718

2323 W Lawrence Ave
Chicago, IL 60625-1913
Phone (224) 364-2273

2650 Ridge Ave
Evanston, IL 60201-1700

3122 N Ashland Ave
Chicago, IL 60657-3014
Phone (773) 687-0999

4901 Searle Pkwy
Suite 150
Skokie, IL 60077-1057

4914 N Clark St
Chicago, IL 60640-3515
Phone (224) 364-2273

501 Skokie Blvd
Northbrook, IL 60062-2802
Phone (847) 504-2300

5211 W Lawrence Ave
Chicago, IL 60630-3615
Phone (224) 364-2273

5238 N Broadway St
Chicago, IL 60640-2304
Phone (224) 364-2273

524 Main St
Evanston, IL 60202-1815
Phone (224) 364-2273

6071 N Lincoln Ave
Chicago, IL 60659-2435
Phone (224) 364-2273

6141 N Cicero Ave
Chicago, IL 60646-4303
Phone (847) 866-7846

6450 W Touhy Ave
Niles, IL 60714-4512

9977 Woods Dr
Skokie, IL 60077-1057
Phone (847) 663-8062

9977 Woods Dr 2ND Floor
Skokie, IL 60077-1057
Phone (847) 663-8370

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.028140ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Oct 11, 2023 Accepting new patients
Endeavor Health Medical Group CurrentSince Oct 11, 2023 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

9977 Woods Dr
Skokie, IL 60077
Phone (847) 663-8540

9977 Woods Dr
Ste 100
Skokie, IL 60077

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1154105252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4212 N WHIPPLE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606182516",
            "telephone_number": "708-305-7882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9977 WOODS DR",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771057",
            "telephone_number": "224-364-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "SOPHIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.028140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.